Long-term outcomes of intravesical therapy for non-muscle invasive bladder cancer.

Objectives: The purpose of the current review was to evaluate the long-term outcomes of intravesical therapy for non-muscle invasive bladder cancer.

Methods: A literature search was performed to identify studies documenting long-term outcomes of intravesical therapy for non-muscle invasive bladder cancer. Data from each study were collected using standardized forms that included information on author, date of study, journal, study type, intravesical therapy used, number of patients, length of follow-up, and outcome measures (recurrence, progression, and disease-specific and overall mortality). This information was then tabulated and summarized.

Results: Of 420 publications identified, 79 were chosen for data abstraction. The long-term impact of intravesical BCG, mitomycin, epirubicin (with or without maintenance/with or without immediate therapy), and transurethral resection alone demonstrated marginal impact on recurrence. However, BCG with or without maintenance appeared to reduce disease progression over the long term compared to other therapies. Data on mortality associated with intravesical therapy were limited. In general, the literature was limited by inconsistent reporting of outcomes and lack of standardization.

Conclusions: Long-term outcomes after intravesical therapy for non-muscle invasive bladder cancer are difficult to asses due to the lack of quality long-term data and inconsistencies in reporting results. It is clear that better long-term data are needed to define the impact of intravesical therapy on the natural history of the disease.